Congenital Dysplasia and Dislocation of the Hip in Children by Professor Dr. Dietrich Tönnis (auth.)

By Professor Dr. Dietrich Tönnis (auth.)

For greater than a hundred years, congenital dislocation of the hip has been a space of shock in orthopedics. This guides at the topic are al­ so much too various to count number. but our wisdom of the fundamental rules of congenital hip dislocation and its administration is consistently being elevated by way of new learn. In Germanspeaking international locations, Kaiser pub­ lished the final finished textbook on congenital hip dislocation in 1958, and Schlegel with a finished instruction manual in 1961. within the Angloamerican international, Coleman's monograph was once pub­ lished in 1978, Somerville's in 1982, and Wilkinson's in 1985. In 1982 Tachdjian compiled a quantity on congenital hip dislocation that con­ tained contributions from forty four specialists. the aim of the current ebook is to supply an outline of our pre­ despatched nation of information of congenital hip dislocation, protecting simple ideas, analysis, equipment of closed and open remedy, and indi­ cations. within the procedure, an test is made to track development within the box from its beginnings to the current time. Many authors describe the prognosis and remedy of congenital hip dysplasia and dislocation by way of particular age teams. We think it really is extra prudent to take an individualized process in response to arthro­ photograph findings and the measure of severity of pathologic alterations. much less emphasis is put right here at the administration of sufferers through age group.

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Additional resources for Congenital Dysplasia and Dislocation of the Hip in Children and Adults

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I.. 5. 6. 6. Curves showing the times of appearance of the capital femoral ossification center. (After Kaiser 1958) Fig. 7. Schematic diagram showing the directional growth of the proximal femur and sites of bone formation. 8). The quality of the stress is also important. Compressive stresses promote cartilage growth, while tensile and especially tangential (shear) stresses inhibit cartilage growth or may even provoke dedifferentiation of the cartilaginous tissue. 8a-d. Drawings by Pauwels on the functional adaptation of bone through longitudinal growth.

This particularly applies to a weight-bearing joint such as the hip. In this case the cause of osteoarthritis may be either extrinsic or intrinsic to the joint. Intrinsic causal factors may relate to the biologic quality of the articular structures or to developmental defects and anomalies, most notably hip dysplasia. Hackenbroch (1957, 1961, 1971) regards hip dysplasia as a pre osteoarthritic ("prearthrotic") deformity which gradually wears the joint away by concentrating loads in a localized too small area.

The growth of the triradiate cartilage leads to expansion and enlargement of the acetabulum. Growth of the acetabular margins alone would tend to close the socket. The depth of the acetabulum and its spherical contour develop largely in response to the presence of the spherical femoral head. Harrison (1961) has confirmed this in experiments with rats. Following resection or experimental dislocation of the femoral head, the acetabulum ceased to develop in depth and surface area. The articular cartilage atrophied and degenerated, while the triradiate cartilage continued to grow and thus maintained the overall length of the iliac wing.

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